ARDS test bank

The nurse calculates the PaO2/FiO2 ratio for the following values; PAO278mmHg FiO2 is 0.6 (60%). What is the outcome in the relationship to the a RDS diagnosing criteria?

130- meets criteria for ARDS 78/0.60=130

What strategies are appropriate for preventing deep vein thrombosis and pulmonary embolus in an at risk patient? Select all that apply A.Sequential compression devices B. Heparin or low molecular weight heparin C. Graduated compression stockings D. Providing education regarding compression ultrasound E. Strict bed rest

A, B, C, Graduated compression stockings sequential compression devices anticoagulation can reduce the risk for DVT. Duplex ultrasonography (compression ultrasound) is a non-invasive imaging study that is useful in detecting lower extremity DVT.

Which of the following are physiological effects of positive and expiratory pressure used in the treatment of acute respiratory distress syndrome? select all that apply A. Open collapsed alveoli B. Improve venous oxygenation C. Increase functional residual capacity D. Prevent collapse of unstable alveoli E. Improve arterial oxygenation

A, C, D, and E Ventilator support for ARDS typically includes PEEP to restore FRC, open collapsed alveoli prevent collapse of unstable alveoli and improve arterial not Venous oxygenation

The nurse caring for a mechanically ventilated patient prepares to include which strategies to prevent ventilator associated pneumonia should be into the patient's plan of care? Select all that apply A. Elevate the head of the bed to 30 to 45° B. Administer antibiotic therapy as prescribed C. Perform regular oral care with Clore hexedine D. Instill normal saline as part of the suctioning procedure E. Drain condensate from the ventilator tubing away from the patient

A, C, E

The nurse is caring for a patient in acute respiratory failure and understands that the patient should be positioned select all that apply A. Sitting in a chair B. High Fowlers C. Supine with the bed flat D. Side lying with head of bed elevated E. Prone with face turn to the left

A,B, D side lying with head of bed elevated sitting in a chair and high Fowlers position are all appropriate ways to position the patient to facilitate gas exchange and comfort

The nurse is concerned that a patient is at increased risk for developing a pulmonary embolus develops a plan of care for prevention to include which intervention? A. Mobility be. Antiseptic oral care. C. Coughing and deep breathing. D. Bedrest with head of bed elevated

A. mobility

The nurse is caring for a patient with cystic fibrosis and understands that treatment consist of which of the following select all that apply A. Nutritional support B. Cardiac monitoring C. Antibiotic therapy D. Airway clearance therapies E. Tracheostomy

A. nutritional support C. Antibiotic therapy D. Airway clearance therapies

A patient at high risk for pulmonary embolism is receiving enoxaparin. The nurse should provide the patient with one explanation? A. I'm going to contact the pharmacist to see if you can take this medication by mouth. B. This injection is being given to prevent blood clots from forming. C. I will contact your primary care provider to discuss why you were getting this medication. D. This medication will dissolve any blood clots you might get

B Enoxaparin or low molecular weight heparin is recommended for patients at high risk for PE it is given subcutaneously not by mouth

What are the diagnostic criteria for ARDS A. Pulmonary artery occlusion pressure of more than 18 B. Acute onset within seven days of critical insult see. Bilateral infiltrates on chest x-ray study D. Decreased cardiac output at E. PA O2/FiO2 ratio of less than 200

B, C, E Diagnostic criterion for ARDS include acute onset within seven days of clinical insult, bilateral infiltrates, or white out, on chest x-ray study and a low PaO2/FiO2 ratio. decreased cardiac output and a high PAOP are seen in pulmonary edema associated with cardiac causes.

When fluid is present in the alveoli what is the result? A. The patient is in heart failure. B. Diffusion of oxygen and carbon dioxide is impaired see. C. Alveoli collapse and atelectasis occurs D. Hypotension occurs

B. Diffusion of oxygen and carbon dioxide is impaired

Which assessment would cue the nurse to the potential of acute respiratory distress syndrome in a patient admitted with respiratory distress? A period normal chest radiograph with enlarged cardiac structures B. Increased peak inspiratory pressure on the ventilator C. PA02/FI02 ratio greater than 300 D. Increased oxygen saturation via pulse ox

B. Increased peak inspiratory pressure on the ventilator

What is the basic underlying pathophysiology of acute respiratory distress syndrome? A. Damage to the right mainstem bronchus B. Decreased capillary permeability C. Damage to the type 2 pnumocytes which produce surfactant D. A decrease in the number of white blood cells available

C. Damage to the type 2 pneumocytes which produce surfactant ARDS results in damage the name of sides, increased capillary permeability, and non-cardiogenic pulmonary edema

The patient diagnosed with acute respiratory distress syndrome would exhibit which symptom? A. Elevated alveolar surfactant levels B. Increased lung compliance with increased FiO2 administration C. Decreasing PaO2 levels despite increased FiO2 administration D. Respiratory acidosis associated with hyperventilation

C. Decreasing PaO2 levels despite increased FiO2 administration Patients with ARDS often have hypoxemia refractory to treatment. Surfactant levels are often diminished in ARDS. Compliance decreases in ARDS. In early ARDS, hyperventilation may occur along with respiratory alkalosis

Which acid base disturbances commonly occurs with the hyperventilation and impaired gas exchange scene in severe exacerbation of asthma? a. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C. Respiratory acidosis

The nurse is discharging a patient diagnosed with asthma instructs the patient to prevent exacerbation by taking what action? A. Limiting activity until patient is able to climb two flights of stairs B. Obtaining an appointment for follow up pulmonary function studies one week after discharged C. Taking all asthma medication as prescribed D. Taking medication on a PRN basis according to symptoms

C. Taking all asthma medication as prescribed

Which treatment can be used to dissolve a thrombus that is lodged in the pulmonary artery? A. Heparin be. Embolectomy C. Thrombolytics D. Aspirin

C. Thrombolytics Thrombolytics are useful in the management of pulmonary embolus and are given to dissolve the clot. Heparin will prevent further confirmation but will not dissolve the clot. An embolectomy is a surgical procedure to remove the clot

Intrapulmonary shunting refers to what outcome? A. Alveoli that are not perfused B. Blood that is scented from the left side of the heart to the right and causes heart failure C. shunting of blood supply to only one long D. Blood is shunted from the right side of the heart to the left without oxygenation

D Shunting refers to blood that is not oxygenated in the lungs

What diagnostic procedure is required to make a definitive diagnosis of pulmonary embolism? Aperiod chest x-ray examination B. Ventilation perfusion scanning C arterial blood gas analysis D. High resolution multi detector CT angiogram

D. High resolution multi detector CT angiogram Also called spiral CT is the preferred tool for detecting PE

What is the most common cause of a pulmonary embolus?

Deep vein thrombosis from lower extremities

In assessing a patient the nurse understands that what symptomology is an early sign of hypoxemia? A. Cyanosis B. Restlessness C. Hypotension D. Clubbing of nailbeds

Β. Restlessness